The efficacy of curcumin/Qing Dai combination in children with active ulcerative colitis: a multicenter retrospective cohort study.

IF 2.1 3区医学 Q2 PEDIATRICS Frontiers in Pediatrics Pub Date : 2024-09-27 eCollection Date: 2024-01-01 DOI:10.3389/fped.2024.1342656

Nurit Loberman Nachum, Nir Salomon, Anat Yerushalmy-Feler, Yael Weintraub, Dotan Yogev, Maya Granot, Yael Haberman, Shomron Ben-Horin, Batia Weiss

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Abstract

Background: Curcumin and Qing Dai (QD) are herbal extracts that recently showed efficacy in treating inflammatory bowel disease (IBD). Since 2016, a combination of curcumin with QD (CurQD) has been employed in our center for management of active ulcerative colitis (UC).

Objectives: We report the effectiveness and safety of CurQD therapy in children with mild-moderate UC or IBD-unclassified (IBD-U).

Design: A multicenter retrospective study.

Methods: Children aged ≤OP18 years who were treated with CurQD during 2017-2021 were included. Disease activity measures were Pediatric UC Activity Index (PUCAI), and fecal calprotectin (FC). The primary outcome was a decrease in PUCAI by ≥10 points, FC normalization (≤100 µg/gr when baseline ≥300 µg/gr) or a ≥ 50% decrease in FC.

Results: Of 30 patients (60% males, mean age 14 ± 3.9 years), 15 (50%), 13 (43%), and 2 (7%) had pancolitis, left-sided colitis and proctitis, respectively. The daily medication dose was 0.5-3 gm QD with 1-4 gm curcumin. Concomitant treatment at induction was corticosteroids (19%), biologics (28%) and 5-aminosalicylic acid (40%). The mean duration of induction was 11.6 weeks [95% confidence interval (CI) 10.2-13.1, range 8-16]. PUCAI decreased from a mean of 31.3 (95% CI 26.6-36.0, range 5-60) to 10.9 (95% CI 7.6-14.4, range 5-35) (n = 26, p < 0.001). FC response and normalization occurred in 11/12 and 7/12 patients, respectively. The median decline in FC was from 749 µg/gm [interquartile range (IQR) 566-1000] to 39 µg/gm (IQR 12-132) (n = 15, p = 0.04). During follow-up (median 8 months, IQR 6-10), 10 patients (33%) flared; five of them regained remission or responded to a treatment change. Of 18 patients treated beyond induction, 12 (67%) achieved clinical response and 10 achieved clinical remission by the end of follow up.

Conclusion: CurQD may be effective and safe as an add-on option to conventional management, for induction and maintenance in children with mild-moderate UC/IBD-U.

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姜黄素/青黛复方制剂对活动性溃疡性结肠炎患儿的疗效：一项多中心回顾性队列研究。

背景：姜黄素和青黛（QD）是草药提取物，最近显示出治疗炎症性肠病（IBD）的疗效。自2016年起，我们中心开始采用姜黄素与青黛（CurQD）联合治疗活动性溃疡性结肠炎（UC）：我们报告了姜黄素联合 QD 治疗轻中度 UC 或未分类 IBD（IBD-U）患儿的有效性和安全性：多中心回顾性研究：纳入2017-2021年间接受CurQD治疗的年龄≤18岁的儿童。疾病活动指标为小儿 UC 活动指数（PUCAI）和粪便钙蛋白（FC）。主要结果是PUCAI下降≥10点、FC正常化（基线≥300 µg/gr时≤100 µg/gr）或FC下降≥50%：在 30 名患者（60% 为男性，平均年龄为 14 ± 3.9 岁）中，分别有 15 人（50%）、13 人（43%）和 2 人（7%）患有胰腺炎、左侧结肠炎和直肠炎。每日用药剂量为 0.5-3 克 QD，姜黄素 1-4 克。诱导时的伴随治疗包括皮质类固醇（19%）、生物制剂（28%）和 5-氨基水杨酸（40%）。平均诱导时间为 11.6 周[95% 置信区间（CI）10.2-13.1，范围 8-16]。PUCAI 从平均 31.3（95% 置信区间 26.6-36.0，范围 5-60）降至 10.9（95% 置信区间 7.6-14.4，范围 5-35）（n = 26，p n = 15，p = 0.04）。在随访期间（中位数为 8 个月，IQR 为 6-10 个月），有 10 名患者（33%）病情复发，其中 5 人恢复了缓解或对治疗方案的改变做出了反应。在接受诱导治疗后的18名患者中，12人（67%）获得了临床应答，10人在随访结束时获得了临床缓解：结论：CurQD作为常规治疗的附加疗法，在轻中度UC/IBD-U患儿的诱导和维持治疗中可能是有效和安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Pediatrics Medicine-Pediatrics, Perinatology and Child Health

CiteScore

3.60

自引率

7.70%

发文量

2132

审稿时长

14 weeks

期刊介绍： Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.